Diabetes: A Family Matter

Maps of Appalachia

The Appalachian region closely follows the spine of the Appalachian Mountains as it traverses from north to south. Beginning in the south western aspects of New York, the region includes parts of 12 states in all and the whole of West Virginia. The numbers of the counties included in this region has changed several times over the years since the region was established by a federal ruling and the formation of the Appalachian Regional Commission (ARC).

Figure 1: The Appalachian Region

Map of the Appalachian Region

Source: Appalachian Regional Commission

Figure 2: Subregions in Appalachia

Map of Appalachian Sub-Regions

Source: Appalachian Regional Commission

Figure 3: Appalachia Defined by ARC

Map of Appalachia as defined by the Appalachian Regional Commission

Source: Appalachian Regional Commission


Distressed Counties of Appalachia

Appalachia is a relatively rural area historically plagued by high poverty rates. In some areas, large pockets of rural areas lag behind much of the nation regarding levels of income, employment, educational attainment, and poverty. The Appalachian Regional Commission uses an economic distress measure to evaluate the progress of counties in the region. These designations are based on individual county-level economic indicators, particularly in relationship to levels of unemployment, poverty, and income. The designations used are distressed, at-risk, transitional, competitive, or attainment.

The criteria for determining this designation is subject to change and should be reviewed for any given year. However, a county could be viewed as “distressed” if it met the following criteria: a poverty rate at least 1.5 times the national average, an unemployment rate (three-year average) at least 1.5 times the national average, and per capita market income (PCMI, which is income less transfer payments) no more than two-thirds the national average. A county could also qualify as distressed if it had poverty rates at least twice the national average and met one of the two remaining criteria. At-risk counties are viewed as borderline economically distressed, those with unemployment rates at least 1.25% of the national average, PCMI no greater than two–thirds the national average, and poverty rates at least 1.25 times the national average. Counties also qualify as “at-risk” if they meet two of the three distressed criteria. Many counties that are identified as distressed or at-risk by ARC have had inferior economic conditions for decades.

Figure 4: Historically Distressed/At-Risk Appalachian Counties

Map of Historically Distressed Appalachian Counties

Note: Darkened counties indicate distressed counties.

Figure 5: County Economic Status in Appalachia, FY 2011

Map of Historically Distressed Appalachian Counties


Diabetes in Appalachian Ohio

This map depicts the findings from randomized phone surveys conducted in 2004 and 2006 using a modified form of the BRFSS of eleven of Ohio’s then 29 counties.

Figure 6: Diabetes in Appalachian Ohio

Map of Diabetes Rates in Select Ohio Counties

BRFSS OH: 7.8±0.6%; BRFSS US: 7.6±0.6%


Appalachian Ohio Local Develpment Districts

The Appalachian Regional Commission uses an index-based county economic classification system to identify the economic status of Appalachian Counties (Attainment, Competitive, Transitional, At-Risk, and Distressed). Index values are based on comparisons of county and national data for the three-year average unemployment rate, per capita market income, and the poverty rate.

Figure 7: Local Development Disctricts in Appalachian Ohio

Map of Diabetes Rates in Select Ohio Counties